Coronary heart disease also known as ischemic heart disease can be described as a condition where the coronary arteries are severely narrowed because of atherosclerosis. When the heart muscle is starved of oxygen and nutrients, it induces chest pain (angina). However, in some cases there is a complete blockage in blood supply leading to heart muscle damage and myocardial infarctions (heart attacks). Some of the common symptoms of coronary artery disease (CAD) to watch out for include chest pain, nausea, dizziness and shortness of breath. It is advisable to seek
medical treatment immediately before the symptoms turn severe and frequent. Remarkable advances in the diagnostic procedures, standard blood flow measurement techniques and medical imaging devices have been helping cardiologists to evaluate CAD in a better way.
Angiography is the first-line diagnostic investigation recommended by cardiologists. Having a detailed physiological analysis of stenosis in the arteries is essential to choose between the varied treatment options – pharmaceutical therapy, FFR-guided percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery. However, several studies and clinical trials have pointed out the limitations of coronary angiography in estimating the degree of luminal narrowing. Standard blood flow measurement techniques and imaging tools can provide a detailed
visualization of the blood flow and performance of the heart. Fractional Flow Reserve (FFR), as a case in point, assists the physicians in identifying the ischemic and non-ischemic lesions. Results published by the FAME (Fractional Flow Reserve Versus Angiography in Multivessel Evaluation) study demonstrated the superiority of FFR over angiography in deciding whether or not to stent the lesions. Moreover, it has been proved that FFR-guided percutaneous coronary intervention assure better outcomes and significantly
lower complication rates.
Medical therapy was considered to be the best approach for patients with stable CAD and significant stenosis. Results from the latest FAME 2 trials conclude that FFR-guided drug-eluting stenting (PCI) is
superior to medical therapy for managing stable coronary disease. Two year data from FAME 2 trials shows a great reduction in the major adverse cardiac events and decrease in the risk of urgent revascularization. As per the latest FAME 2 study results, FFR-guided PCI plus optimal medical therapy shows sustained clinical and economic benefits when compared with medical therapy alone.
